To state the obvious, poop problems are the worst. Whilecramping, constipation, and diarrhea are a drag for everyone, those who suffer from irritable bowel syndrome (IBS) have to live with those symptoms on a daily basis. IBS is a gastrointestinal syndrome characterized by chronic abdominal pain and altered bowel habits in the absence of any organic cause, says Niket Sonpal, M.D. It is the most commonly diagnosed gastrointestinal condition. The prevalence of IBS in the United States is estimated from population-based studies to be approximately 10 to 15 percent but, in my experience, I feel the prevalence is much higher.

Unfortunately, women are twice as likely as men to have IBS, according to theU.S. Department of Health and Human Services. Women can attribute their likelihood of getting IBS to the fact thathormonescontribute to flare-ups and estrogen and progesterone both rise and fall during the monthly menstrual cycle, says Sonpal. Because these hormone receptors are found in the G.I. tract, their fluctuations manifest symptoms. Furthermore, womens symptoms can differentiate from one another because, in addition to hormonal fluctuations, IBS flare-ups can be influenced by emotional health and the guts microbiome as well.

IBS is what Sonpal calls a diagnosis of exclusion, meaning a physician should rule out all other possible causes of symptoms first. Because of that and the way women uniquely experience IBS, it can be difficult to diagnose. After all, how do you tell if its IBS or intense period cramps or anxiety?